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Sunday, January 15, 2012

Depressed Mothers in the child welfare system

Kohl, Kagotho and Dixon have just published a rather interesting piece of research regarding depressed mother's parenting. They looked at a child protection population. As they note, women are more likely to experience depression as compared to men. Further, those referred to a child protection system will more likely have cumulative stressors that may add to the problems. Women are more likely to be the caregivers in child welfare families and depression is a common concern. Depression has also been found to have a relationship with dysfunctional parenting.

These researchers looked at 92 sampling units across 36 states in the USA. The sample was robust with 5501 children. The families were followed for 36 months and comprised those where the children spent no more than 5% of time in an out of home placement. Thus, while this is a child welfare population, it is one where family preservation is occurring. This might suggest that the population is less severe than might other samples be, but it also afforded the researchers a chance to see what unfold with parenting when the parent stays in that active role. Given the focus of the research, the mother also needed to be the primary caregiver, but could be biological, adoptive or step mother.

The results showed some surprising conclusions, the most important being that it did not replicate the previously seen conclusion that there is a connection between depression and harsh parenting. However, it did increase from 9% to 14% over the course of the study. That is a statistically significant increase. Even so, harsh parenting was a rare event. This is an important result.

The connection between neglectful and emotionally abusive parenting was found. The latter grew over time which is of course, rather concerning. As these authors note,

These high rates of ongoing emotional maltreatment after a CPS referral are a concern, given the long-term adverse consequences of experiencing this type of maltreatment in child- hood. Emotional maltreatment has been found to be an important contributor of psychological adjustment in young adulthood, with higher levels of emotional maltreatment being associated with poorer outcomes (Miller-Perrin, Perrin, & Kocur, 2009).(p.223). 
In their discussion about the implications of their work for clinical practice, the authors note that parents in child protection system are much less likely to receive mental health services as opposed to the overall population. That is worrisome given the implications for these families. This result comes from the USA and may vary across jurisdictions. None the less, it is an acute reminder that assessing for mental health concerns remains a priority in child protection populations. Getting mental health services in place may well serve to increase family preservation outcomes and also reduce such parenting practices as emotional abuse and neglect.

This research underlies the value of good assessment and then connection to needed services.

Reference:

Kohl, P.L., Kagotho, J.N. & Dixon, D. (2011). Parenting practices among depressed women in the child welfare system. Social Work Research, 35, (4), 215-225.



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